Director - Market Access (Remote) - United States Job Openings

United States Job Openings

Caris Life Sciences

Director - Market Access (Remote)

FULL TIME

November 14, 2024

Position Summary

The Director of Market Access drives medical policy coverage initiatives and contracting strategies within assigned regional managed care organization(s), and employer groups (employee benefit plans). Responsible for obtaining positive payer coverage policies, securing in-network contracting and maximizing reimbursement while minimizing access barriers for patients and providers. Travel is required at least within region and at requested times, outside of incumbent’s region to provide national support. Ability to manage complex contracting documents ensuring business needs are met within the agreements and make recommendations on legal review and pull-through initiatives coordinated with marketing and sales teams.

Job Responsibilities

Contract and be an in-network provider for insurance companies and group payer organizations within region
Manage complex contract negotiation and work with cross functional departments to bring the contracting process to closure
Manage existing relationships with existing contracted insurance companies
Initiate and develop new relationships to sign contracts with targeted payers, track meetings and progress
Develop and implement strategies that lead to successful acceptance of Caris Life Sciences testing into payer medical policy guidelines
Maximize reimbursement by negotiating the highest possible reimbursement rates and holding payers to contract terms
Stay up to date on trends in the managed care market and develop strategy with senior management to address the changes and maintain acceptable reimbursement rates
Prepare, coordinate, and manage contract negotiation process
Identify and evaluate opportunities and financial terms for MCOs, GPOs, IPAs, and other healthcare systems
Assess potential legal risk in the context of contract provisions. Prepare letters of agreement and key contract provisions
Identify and target specific market segments for development, including key payers, employers, or other managed care organizations
Serve as the principal contact with assigned payers, employers and providers and review proposed agreements within assigned territory
Prepare responses to Request for Proposals (RFP)
This role manages multiple project deadlines while working collaboratively with a team
Directly interact with clients and other stakeholders, either in person, via teleconference or email
Develop advocacy from clinicians, society, and patient sources, and ensure effective communication to key stakeholders, including medical and trade associations
Ensure compliance with relevant regulations and standards for product access and market entry
Assist field representatives with reimbursement challenges
Attend conferences and physician meetings
Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork

Required Qualifications

Bachelor’s Degree in Business, Marketing, Science, or related field
5+ years of experience in any of the following areas: contracting and coverage with large national payers, medical group contracting, sales, sales leadership in biotech, device or diagnostic laboratory companies, or extensive experience working in health plan contracting, coverage or case management
5+ years of reimbursement programs in pharma, lab, biotech, and/or devices
Possession of a valid driver's license
Demonstrated ability to perform the essential duties of the position with or without accommodation
Authorization to work in the United States without sponsorship
Strong presentation skills and the ability to speak confidently to all levels of an organization require
Ability to develop a value proposition and effective business case that will influence medical policy
Ability to present clinical data, scientific findings, and complex information in a persuasive manner to a variety of audiences
Effective English communication skills, both written and verbal
Outstanding influencing, interpersonal and networking skills to drive successful relationship building
Strong knowledge of Microsoft Office Suite (Power Point and Word)

Preferred Qualifications

Proven success at negotiating contracts with payers that yield reimbursement at desired ASP
Reimbursement contracting and coverage experience, preferably in molecular diagnostics or life sciences
Able to work independently with little direction, capacity to research and stay current on managed care and healthcare industry trends
Possess a solid understanding of the molecular diagnostic testing market: products, companies, and technology
Best demonstrated track record of developing and managing complex negotiations with multiple decision makers
Outstanding problem solving, project and program management skills
Proven, effective time management, expense reporting, prioritization, and delegation skills
Effective presentation skills; able to present ideas to customers in a way that produces understanding and impact
Existing relationships with individuals at insurance companies and group payer organizations

Training

All job-specific, safety, and compliance training will be assigned based on the job functions associated with this role

Physical Demands

Ability to lift up to 10 pounds for approximately 10% of a typical working day
Ability to work seated for approximately 80% of a typical working day Ability to work standing for approximately 20% of a typical working day
Ability to work in front of a computer screen and/or perform typing for approximately 80% of a typical working day
Ability to comply with any applicable personal protective equipment requirements
Ability to travel approximately 50% of working time within region and limited time outside of region for national or regional meetings

Other

Participation in an on-call rotation for IAM support may be required
Other duties as assigned

Annual Hiring Range

$170,000 - $190,000

Actual compensation offer to candidate may vary from posted hiring range based upon geographic location, work experience, education, and/or skill level. The pay ratio between base pay and target incentive (if applicable) will be finalized at offer.

Description of Benefits

Highly competitive and inclusive medical, dental and vision coverage options
Health Savings Account for medical expenses and dependent care expenses
Flexible Spending Account to pay for certain out-of-pocket expenses
Paid time off, including: vacation, sick time and holidays
401k match and Financial Planning tools
LTD and STD insurance coverages, as well as voluntary benefit options
Employee Assistance Program
Pet Insurance
Legal Assistance
Tuition Assistance

Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check ( applicable for certain positions) and reference verification.

This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

We regret to inform you that this job opportunity is no longer available as it has expired

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